Pulmonary Embolectomy for Acute Massive Pulmonary Embolism

Dauphine, Christine; Omari, Bassam

doi:10.1016/j.athoracsur.2004.08.081

Cited by 109 publications

(92 citation statements)

References 27 publications

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“…Early initiation of treatment significantly reduces morbidity and mortality [2,3]. Therefore, timely and accurate diagnosis is of utmost importance.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Pulmonary Artery Embolism: Comparison of Single-Source CT and 3rd Generation Dual-Source CT using a Dual-Energy Protocol Regarding Image Quality and Radiation Dose

Petritsch¹,

Kosmala²,

Gassenmaier³

et al. 2017

Fortschr Röntgenstr

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ZUSAMMENFASSUNGZiel Das Potential der Dritt-Generation Dual-Source CT (DSCT) in der Lungenemboliediagnostik wurde bis dato noch nicht ausführlich untersucht. Ziel dieser Studie war es, Strahlendosisparameter sowie subjektive und objektive Bildqualität des aktuellsten DSCT Scanners im Single-Energy und Dual-Energy (DE) Modus mit einem herkömmlichen pulmonalen Standard CTA Protokoll am 64-Zeilen CT (SSCT) zu vergleichen. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. Material und Methoden▪ Die Dual-Energy CT bietet potentiell zusätzliche Informationen durch die Erstellung von farbcodierten Jod-Karten. ABSTR AC TPurpose To compare radiation dose, subjective and objective image quality of 3 rd generation dual-source CT (DSCT) and dual-energy CT (DECT) with conventional 64-slice singlesource CT (SSCT) for pulmonary CTA.Materials and Methods 180 pulmonary CTA studies were performed in three patient cohorts of 60 patients each. Group 1: conventional SSCT 120 kV (ref.); group 2: single-energy DSCT 100 kV (ref.); group 3: DECT 90/Sn150 kV. CTDIvol, DLP, effective radiation dose were reported, and CT attenuation (HU) was measured on three central and peripheral levels. The signal-to-noise-ratio (SNR) and contrast-to-noise-ratio (CNR) were calculated. Two readers assessed subjective image quality according to a five-point scale.Results Mean CTDIvol and DLP were significantly lower in the dual-energy group compared to the SSCT group (p < 0.001 [CTDIvol]; p < 0.001 [DLP]) and the DSCT group (p = 0.003 [CTDIvol]; p = 0.003 [DLP]), respectively. The effective dose in the DECT group was 2.79 ± 0.95 mSv and significantly smaller than in the SSCT group (4.60 ± 1.68 mSv, p < 0.001) and the DSCT group (4.24 ± 2.69 mSv, p = 0.003). The SNR and CNR were significantly higher in the DSCT group (p < 0.001).Subjective image quality did not differ significantly among the three protocols and was rated good to excellent in 75 % (135/180) of cases with an inter-observer agreement of 80 %.Conclusion Dual-energy pulmonary CTA protocols of 3 rd generation dual-source scanners allow for significant reduction of radiation dose while providing excellent image quality and potential additional information by means of perfusion maps. Key Points:▪ Dual-energy CT with 90/Sn150 kV configuration allows for significant dose reduction in pulmonary CTA. ▪ Subjective image quality was similar among the three evaluated CT-protocols (64-slice SSCT, single-energy DSCT, 90/Sn150 kV DECT) and was rated good to excellent in 75% of cases.

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“…Early initiation of treatment significantly reduces morbidity and mortality [2,3]. Therefore, timely and accurate diagnosis is of utmost importance.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Pulmonary Artery Embolism: Comparison of Single-Source CT and 3rd Generation Dual-Source CT using a Dual-Energy Protocol Regarding Image Quality and Radiation Dose

Petritsch¹,

Kosmala²,

Gassenmaier³

et al. 2017

Fortschr Röntgenstr

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show abstract

“…However, there is no absolute confidence in the fact that catheter thrombolytic therapy is more preferable than systemic thrombolysis and heparin-therapy. Transcatheter thrombectomy allows fragmenting embolic material which can further have a high probability of getting into the periphery pulmonary system and increasing the risk of pulmonary hypertension and its chronization [19].…”

Section: Discussionmentioning

confidence: 99%

“…The analysis of our data (lack of lethality for the last six years in more than 120 embolectomies), as well as the experience of Russian and foreign colleagues, allows us to consider open embolectomy the most appropriate method of treating pregnant women, because they give an opportunity not only to save a woman's life, but also to prolong pregnancy and deliver a healthy child. The optimal variant of surgery is embolectomy from pulmonary arteries in conditions of AC on the beating heart without the aorta compression [19][20][21]. Beyond any doubts it requires an operation under the conditions of a specialized cardio-surgical hospital by surgeons experienced in operations on the heart.…”

Section: Discussionmentioning

confidence: 99%

Experience in Diagnostics and Surgical Treatment of Pulmonary Embolism in Pregnant Women

Medvedev¹,

Максимов²,

Немирова³

et al. 2017

Sovrem Tehnol Med

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“…Дан-ная операция показана при неэффективной ТЛТ, у пациентов, рефрактерных к ТЛТ, а также при тромбозе правого предсердия. Стратегия хирурги-ческой ТЭ будет наиболее успешна, если проце-дура проводится в условиях компенсированного обструктивного шока [11,[35][36][37][38][39].…”

Section: выбор метода реперфузииunclassified

Algorithm of Intensive Care of Acute Pulmonary Embolism: Emphasis on the Invasiveness

Малышенко¹,

Попов²,

Хаес³

et al. 2015

Kompleks. probl. serdečno-sosud. zabol.

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Pulmonary Embolectomy for Acute Massive Pulmonary Embolism

Cited by 109 publications

References 27 publications

Diagnosis of Pulmonary Artery Embolism: Comparison of Single-Source CT and 3rd Generation Dual-Source CT using a Dual-Energy Protocol Regarding Image Quality and Radiation Dose

Diagnosis of Pulmonary Artery Embolism: Comparison of Single-Source CT and 3rd Generation Dual-Source CT using a Dual-Energy Protocol Regarding Image Quality and Radiation Dose

Experience in Diagnostics and Surgical Treatment of Pulmonary Embolism in Pregnant Women

Algorithm of Intensive Care of Acute Pulmonary Embolism: Emphasis on the Invasiveness

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